A new study finds that a younger age at a girl’s first period is associated with a higher risk of becoming an adult woman with type 2 diabetes and cardiovascular complications.
Age at menarche, type 2 diabetes, and cardiovascular disease complications in US women younger than 65 years: NHANES 1999-2018
Summary
Background
Diabetes and diabetes complications are increasing in American adults under age 65, while the onset of menarche at a younger age is also increasing.
We examined the associations of age at menarche with type 2 diabetes among women <65 years and with cardiovascular disease (CVD) complications among women with diabetes.
Methods
Using the nationally representative cross-sectional National Health and Nutrition Examination Survey 1999-2018, women aged 20 to 65 years without cancer were included in the current analysis. Diabetes was defined as a self-reported diabetes diagnosis. CVD was defined as coronary heart disease or stroke. Age at menarche was the self-reported age of first menstruation and was categorized as ≤10, 11, 12, 13, 14, and ≥15 years.
Results
Of 17,377 women included in the analysis, 1,773 (10.2%) reported having type 2 diabetes. Younger age at menarche was associated with type 2 diabetes compared with the mean age at menarche of 13 years, after adjustment for age, race/ethnicity, education, parity, menopausal status, and family history of diabetes, smoking, physical activity, alcohol consumption, and body mass index (p for trend = 0.02).
Among women with diabetes, younger age at menarche was associated with stroke with similar adjustment (p for trend = 0.03), but not with total CVD.
Extremely early age at menarche (≤10 years) was significantly associated with stroke (adjusted OR 2.66 (95% CI 1.07 to 6.64)) among women <65 years with diabetes with an adjustment similar.
Conclusions Younger age at menarche was associated with type 2 diabetes among young and middle-aged women in the US and with stroke complications among these women living with diabetes. |
Comments
Diabetes and its complications, such as stroke or coronary heart disease, are increasing among American women under age 65, while at the same time more girls are experiencing their first periods earlier.
Using data from 17,377 women aged 20 to 65 years in the National Health and Nutrition Examination Survey (NHANES), researchers investigated the associations of period onset with the risk of type 2 diabetes and associated cardiovascular complications among women aged 65 years or less.
They found that girls who had their first periods before age 13 had a higher risk of type 2 diabetes compared to those whose menstrual cycles came at age 13 or later. Among women who developed type 2 diabetes, those who had an extremely early first period (before age ten) also had an increased risk of stroke, although not cardiovascular disease overall.
The authors state: "A possible explanation for the pathway may be that [these] women are exposed to estrogen for longer periods, and early [menstruation] has been associated with higher estrogen levels."
What is already known
The median age of diabetes complications is decreasing, paralleling the decreasing age of menarche in the US and worldwide.
Age at menarche has been associated with increased risk of diabetes and cardiovascular disease (CVD) independently, but it remains unclear whether age at menarche is a risk factor for CVD complications among younger women. with diabetes.
What this study adds
Age at menarche appears to be an early risk factor for stroke complications among younger women with diabetes.
Younger ages at menarche were associated with premature stroke events among women <65 years with diabetes.
How it can affect clinical practice
Women with early exposures, such as menarche at a young age, should be further examined for research on diabetes and its prevention and strategies for the progression of diabetes complications.
